The Developmental Disabilities Administration (DDA) is a division of the Department of Social and Health Services (DSHS) that assists persons with developmental disabilities and their families to obtain services and support based on individual preferences, capabilities, and needs. People served by the DDA live in the community, in residential habilitation centers, and in institutional settings.
Eligibility for DDA services depends on whether a person has a qualified developmental disability, has a functional need, and meets certain income and asset standards. The services provided are designed to promote everyday activities, routines, and relationships common to most people, and include housing, medical care, personal care, and job training.
To qualify for DDA services, a person must have an intellectual disability, cerebral palsy, epilepsy, autism, or another neurological or other condition similar to an intellectual disability or require treatment similar to that required for individuals with intellectual disabilities. The disability must:
Not all individuals who qualify for DDA services are eligible for paid DDA services, and not all individuals who are eligible for paid DDA services receive them. The caseload of individuals receiving paid services through DDA Medicaid waivers is capped by funded capacity. Individuals who qualify for DDA services but are not receiving them are known as being on the No-Paid Services caseload. As of February 1, 2022, a total of 10,671 individuals were on the No-Paid Services caseload.
The DDA may not use intelligence quotient (IQ) scores as the sole determinant of developmental disability.
Beginning July 1, 2025, the DSHS may not use IQ scores in determining eligibility for any developmental disability-related programs or services. The DSHS must maintain eligibility for persons previously determined eligible based in whole or in part on IQ score and may not require such persons to meet any new eligibility requirements in response to the discontinuation of the use of IQ scores. An IQ score may be used to establish a presumption of eligibility. The DSHS may continue using a diagnosis from qualifying diagnosticians and adaptive functioning assessments to determine eligibility and substantial limitation.
The substitute bill removes the requirement for the DSHS to submit a report to the Legislature with an assessment of the alternatives to using IQ scores and a plan to discontinue the use of IQ scores. The substitute bill requires the DSHS to maintain eligibility for developmental disability-related programs and services for persons previously determined eligible based in whole or in part on IQ scores and allows IQ scores to be used to establish a presumption of eligibility. The substitute bill also allows the DSHS to continue using a diagnosis from qualifying diagnosticians and adaptive functioning assessments to determine eligibility and substantial limitation.
(In support) The IQ scores are an outdated and antiquated measure based on racist and eugenic ideas. The IQ scores are not a good measure of support needs and are weighted too heavily in determining eligibility for services. Eligibility should be based on functional assessment and diagnosis. People can have very high IQ scores but need help with daily needs, such as bathing and dressing. People with borderline IQ scores are denied services they need. The state needs to build and fund systems that serve people with developmental disabilities. The IQ scores act as a budget gatekeeper that prevents people from accessing needed services. Fetal alcohol syndrome should be included in the definition of developmental disability.
(Opposed) There are lots of questions about how this bill will impact people currently receiving services. People currently receiving services need to be able to weigh in on any changes to eligibility criteria.
(Other) This bill may create unintended consequences. It is already difficult to qualify for services. The IQ scores should be allowed as a presumptive determination for services.
The second substitute bill requires that beginning on July 1, 2025, when the Developmental Disabilities Administration (DDA) has capacity and funding to enroll additional individuals in its Medicaid waivers, it must prioritize individuals who were determined eligible for paid DDA services but were not receiving them as of June 30, 2025.
(In support) The use of intelligence quotient (IQ) scores is not necessary for DDA eligibility determinations because individuals must already show that they have support needs. The IQ standard causes harm to an already under-resourced community.
(Opposed) None.